Site Improvement through Monitoring Systems Assessment: Feedback Report for the Association for Reproductive and Family Health’s Integrated Child Health and Social Services Award 2 in Lagos State, Nigeria

The assessment aimed to review whether processes for HIV service provision adhered to President's Emergency Plan for AIDS Relief (PEPFAR) standards at two community-based organizations (CBOs) in Lagos State. Between November 30 and December 1, 2022, the SIMS assessment team visited the Chamagne Foundation and the Rhoda Haven Network for Women Living with HIV to conduct comprehensive assessments. The assessments aimed to review whether processes for HIV service provision adhered to PEPFAR standards. The results of the assessment provided information to support strengthening structures and processes for quality service delivery. The assessment team observed several strengths at both sites, including the availability of written procedures for stakeholder engagement, patient rights, stigma, and discrimination policies, child safeguarding policies, and standard operating procedures (SOPs) for the management of orphans and vulnerable children (OVC). Additionally, the availability of post-gender-based violence (GBV) services and systemic archiving of all required SOPs and guidelines were observed at the Chamagne Foundation. However, the assessment team identified several weaknesses at both sites. At the Chamagne Foundation, 30% of client charts reviewed did not have evidence of routine monitoring for care and treatment services. At the Rhoda Haven Network for Women Living with HIV, lack of evidence for routine review on the referral register was observed. The assessment team made several recommendations to the ARFH Integrated Child Health and Social Services award 2 project for health system strengthening. At the Chamagne Foundation, a routine folder audit should be conducted to identify missed opportunities for service provision and documentation. At the Rhoda Haven Network for Women Living with HIV, all hard and soft copy registers should be routinely reviewed and signed off. The assessment team used the new SIMS 4.2 tool, which was deployed during the assessment. The tool was organized into several sets, including Set 1A (All Sites – General), Set 1C (All Sites – Data Quality), and Set 6 (Adolescent Girls and Young Women, Gender-Based Violence, and Orphans and Vulnerable Children). The assessment team provided copies of the dashboards containing the summary of the assessment findings to the sites and the implementing partner's representatives. Overall, the assessment aimed to support strengthening structures and processes for quality service delivery at the two CBOs in Lagos State. The assessment team identified several strengths and weaknesses at both sites and made recommendations for health system strengthening.